The Smarter Plan - Caring for your skin before & after surgery

Dr Gabriel Doucas & Ingrid Katz elaborate how the combination of skin treatments and facial cosmetic surgery complement each other so beautifully.

As our bodies age, the skin changes... and it isn’t in a positive way. Our skin density decreases, meaning the skin becomes thinner. Less density leads to less plumpness, which translates to more fine lines and wrinkles. This loss in density is a result of decreased collagen production, depletion of subcutaneous fat, paucity in the availability of the vascular system (as it is pushed down) and a general breakdown of the finer structures of the skin.

The skin loses elasticity, making it sit less tightly on the underlying tissues. Additionally, our metabolism slows down with age - resulting in a slower skin cell turnover. More dead skin cells then hang on at the surface of the skin, which can result in impaired wound healing.

Seeking surgery to improve lines, sagging skin and ageing effects will only take you so far. The surface skin quality will still be left lacking. And to be honest, if you are going to spend the money and go through the process of surgery, why not ensure the absolute best result by attending to the skin at the same time? The same can be said for therapeutic skin treatments alone too. It can only take you so far. That’s why the combination of skin treatments and surgery complement each other so beautifully.

Skin Therapist’s Perspective

Skin enhancing treatments such as skin peels, lasers and needling have advanced tremendously over the last few years, to the point where we now have an array of treatments available to us to meet every skin concern. What is actually transpiring when undergoing any of these treatments is a wound healing response in the skin. The number of actions being initiated in the skin will depend on the treatment depth, design and the number of areas worked on – and it’s these actions that ensure the skin is rejuvenated, regenerated and resurfaced.

The skin’s “action centre” is then set into motion to increase the metabolism of cell turnover, where fresh new healthy cells arrive to the surface at a faster rate. This improves collagen production (which means better structure, density and hydration) while strengthening the underlying structure.

The above-mentioned improvement will also ensure the skin is less flaccid and has more elasticity for better placement and manoeuvrability over the face. It additionally creates improved blood supply, which means a better healing capacity and a more luminous or healthier complexion. All of the above will only assist in providing a surgeon with a better canvas to work with and thus enhance the end result. If surgery is not the objective, the skin will be improved in all these areas to delay the ageing process - and ensure a more balanced, healthier and better looking skin.

Surgeon’s Perspective

Facial rejuvenation has gone through a wonderful roller coaster of advancement, growth, skill improvement, misinformation and a fair amount of disappointment. The need for the surgeon to stamp his authority in all matters aesthetic has lost favour over the past decade. The domain of facial cosmesis is shared between many role players that include the plastic surgeon, aesthetic physician, skin therapist, dentist, maxillo-facial surgeon, make-up artist and even your hair stylist.

Surgery, though very important, is one of the many modalities available to regain one’s youth. Non-surgical options that include fillers, neurotoxin, threads, etc. have been invaluable in postponing the need for facelift surgery - but have definitely not eradicated its need. Facelift surgery alone, or in combinations with eyelid, neck, brow rejuvenating surgery and fat tissue transfers, is here to stay.

What makes it more exciting though, is that the combinations of surgical and nonsurgical solutions, has led to better, more reliable and repeatable results. However, the foundation that needs to be laid is the preparation of the actual skin - the canvas that displays all the efforts made to better its appearance.

It seems almost incredulous these days, that for so long we omitted this part of the management in our surgical plan. So it goes without saying that the better the skin has been prepared by our skin therapist colleagues, the better our surgical outcomes will be. The sequence of events should be skin first and surgery second, and once the surgery has come and gone, the skin must continue being treated to ensure longevity and enhancement of the result.